E-cig use among teens has reached epidemic proportions

Tuesday

Jan 29, 2019 at 1:47 PMJan 29, 2019 at 1:47 PM

While prevention efforts have lessened the number of cigarette smokers, the allure of e-cigs makes them as dangerous, or even worse, for teens.

That mango smell wafting from your son’s room is not incense; your daughter’s new fancy USB stick doesn’t store data. It isn’t all that it might seem. Electronic Nicotine Delivery Systems (ENDS), also known as e-cigs or vapes, are new sweet-tasting smoking apparatuses that are not your grandfather’s Marlboros. They are sleekly designed, easily hidden, highly addictive and are quickly making their way into the hands, and lungs, of teens.

A recent study from the Centers for Disease Control and Prevention (CDC) found that more than three million teens are currently using ENDS, up 75 percent since last year. And in December, the U.S. Surgeon General issued a rare public health advisory warning Americans of the dangers of e-cigarettes. With no more than three years of usage data, there is no real evidence of the long-term physical effects of ENDS. While adult smokers use ENDS as a tool to mitigate or end their cigarette habit, underage smokers are lured by the design of these sleek devices and the myth that vaping is “healthier” than cigarettes. The result: millions of teens are nicotine addicts.

THE ADDICTION IS REAL

Nicotine addiction can begin with just one cigarette. As the drug enters your system via your lungs, it quickly absorbs into your bloodstream and reaches your brain within eight seconds, releasing adrenaline and giving you a sense of relaxation. Likened to the effects of cocaine, according to CDC, it causes your heart and breath to quicken, your veins to constrict and your brain to be electrically charged – firing off your brain’s pleasure neurons. Those euphoric feelings are fleeting, so your body wants another cigarette and another; the more you smoke, the more tolerant your body becomes. Smokers must increase their nicotine intake to feel tobacco’s addictive effect.

“Nicotine is an extremely addictive drug, and the adolescent brain is particularly susceptible to its effects. Nicotine is not good for the body, but the main risk is for addiction,” says Samuel Evans, MD, pulmonologist at Newport Pulmonary Medicine. “Underage smokers, in addition to breaking the law, are at tremendous risk for long-term and sometimes irreversible health problems. The lungs continue to develop into our late teens/early 20s. The earlier our lungs are exposed to damaging substances, the more extensive the long-term effects can be.” It is this addiction that concerns parents of teens and cigarette smokers alike, but for different reasons.

ENTER ENDS

From tank devices to rechargeable e-cigarettes, these Electronic Nicotine Delivery Systems are used to vaporize liquid nicotine, which is then inhaled. “All vaping devices work the same way. You have some sort of liquid container, whether it be a tank, pod or cartridge,” explains Alicia Anthony of Splash Vapes in Middletown. “When you activate the device by either pressing a button or taking a draw from the mouthpiece, the internal atomizer steams the liquid, which is the vapor you inhale.” In addition to nicotine, ENDS can contain flavorings such as fruit, candy, peppermint, bubble gum and chocolate, many of which are appealing to children and teens. Anthony explains that it is important to note that these devices were originally designed as an alternative to cigarette smoking for adults, one that is considered less harmful than its tobacco counterpart. She notes that e-cigs are best used by adult smokers who want to cut back, or even quit, their cigarette addiction. “For many adult smokers, the device gives them a smoother transition while getting off the cigs,” Anthony says. “Let me be clear: If you are not a smoker, do not pick up a vape. It’s stupid to knowingly give yourself an addiction!”

One of the better-known ENDS is JUUL, a thin, slick device that houses small pods of liquid nicotine. Studies show that each JUULpod is equivalent to one pack of cigarettes and many vapers are using at least one pod a day. Evans explains that e-cigarettes can expose users to several chemicals besides nicotine, including carbonyl compounds and volatile organic compounds that have known adverse health effects. “Why are people inhaling anything other than air??! The extent of lung damage caused by vaping is not completely understood and is being actively studied,” he says. “There is no good evidence that it is safe, though the health risk may be less than with conventional cigarettes. Less risk does not mean no risk. There may be a role for ENDS in current smokers trying to quit.”

Hunter Williams*, 26, of Newport says that he began using tobacco his freshman year in college as a mix-in with marijuana. He says that many times, teens use tobacco as a “filler” when they don’t have enough weed to roll a joint; this is called a “spliff.” “Eventually I became addicted to the tobacco. I recently began using JUUL after my dad quit smoking by using it. He’s been smoking cigarettes since he was 11 years old,” Williams explains. “Seeing the change he was able to make made me feel like I could too.” According to their makers, ENDS were originally created to give cigarette addicts a safer method of nicotine intake without the added harsh chemicals, therefore alleviating the toll it takes on a user’s body, such as breathing problems and chronic cough. Anthony says that after two weeks of vaping, she no longer felt any of the negative physical effects she felt from smoking. “E-cigs are less harmful than traditional cigarettes. For adult smokers needing to quit, vaping is safer,” she says. “All we want to do is show smokers there is another way. We are not enemies to the public; the only ones we want to hurt is big tobacco, who we feel were our oppressors. We just want to save people.”

TEENS

While ENDS are claiming to “save” adult smokers, they are becoming a harmful addiction for adolescents. Lori Verderosa, director of Middletown Prevention Coalition, says that the use of ENDS among Middletown’s youth and beyond has reached an epidemic proportion of growth over the past few years. “It has skyrocketed, with JUULs as the most popular ENDS. In fact, now we have a new verb: ‘JUULling,’” she says. “Recent data shows that young adults who use e-cigs are more than four times as likely to begin smoking tobacco cigarettes within 18 months compared to their peers who do not vape.”

Scarlet Grace*, a 19-year-old University of Rhode Island student from Jamestown, began smoking ENDS while a high school junior, when she found one on her desk that someone had left behind. “Most of my friends now smoke JUULs,” she says. “It relaxes you. But now a lot of them are addicted.” One of the appeals of JUULs, Grace says, is that they are easy to obtain and conceal. “Kids order JUULs online or get their older friends to buy them,” she explains. “Kids smoke them in the bathroom or in their bedrooms. They light a candle or incense so their parents think that’s where the smell is coming from.” Grace also says that kids charge the devices on their laptops, and because they look like USB chargers, adults don’t realize what they’re doing.

“There is an alarming increase in youth and young adult ENDS usage. Usage in the 18- to- 24-year-old group, according to data recently compiled by the Surgeon General, surpasses that of adults 25 years and older,” says Evans. “ENDS are now the most commonly used tobacco product among youth and have surpassed conventional cigarettes. Among middle and high school-aged students, ENDS use has more than tripled since 2011.” One person who sees this statistic firsthand is Middletown High School Principal Dennis Soares, who confirms that many students are not cognizant what harm they face by using ENDS. “I’m not sure if they actually realize the chemicals that are inside them. On our end, we do the best we can here to educate them on this,” he says.

While prevention efforts have lessened the number of cigarette smokers, the allure of ENDS makes them as dangerous, or even worse, for teens. Both Soares and Verderosa say that the first line of defense against ENDS is to educate students about the dangers. Soares says his goal, and that of the Prevention Coalition, is not to punish students but to educate them about the realities of ENDS usage. “The devices are advertised to make them very attractive. If you were to look at them from a set of teenage eyes, you’d understand what I am talking about,” says Soares. “Sweet flavorings, colorful/animated labels, and big signs on window fronts of stores. I feel we battle more than we think.” Verderosa says that the coalition recently conducted a focus group with local teens and many of them didn’t know that vaping devices contained nicotine. What students did say was that ENDS are “sleek, discreet, cool and sexy.” She says the number-one defense is an active and curious parent. The more parents speak to their tweens and teens about the truth of ENDS usage, the more likelihood that kids won’t start vaping. “We also need a community-wide approach that includes schools, prevention coalitions, parents and other youth-serving organizations, like the YMCA and little league programs,” she says. “We all need to be talking the same language and have a community strategy to address this problem.”

NO BUTTS ABOUT IT

The bottom line is that while ENDS may be a good tool to help adult smokers address their addiction, they are also posing a great health risk to today’s youth. “Our lungs evolved to breathe one thing and one thing only: air. We have excellent air quality and we shouldn’t compromise it by inhaling noxious and addictive things,” says Evans. “Vaping seems like it is harmless, but it is definitely not. Again, vapor may be less damaging than tobacco smoke, but it is still not safe.”

// “There is no good evidence that it is safe, though the health risk may be less than with conventional cigarettes. Less risk does not mean no risk.” -- Samuel Evans, MD, pulmonologist, Newport Pulmonary Medicine

JUUL announced in November 2018 that it would no longer sell the popular fruit- and candy-flavored nicotine pods in retail stores, including flavors such as mango, fruit, crème and cucumber. While these flavors are still available online, JUUL states that it is enacting a more stringent age-verification policy to lessen the possibility that its products land in underage hands. “We don’t let anyone under the age of 18 in our store and we card anyone who appears under 30,” says Anthony. “All of the responsible vapor stores in Rhode Island are part of a group. When we come across underage kids who are habitually trying to purchase from our stores or flash fake IDs, we share the info and camera shots with each other so we can be on the lookout. We don’t want kids vaping.”

*Names have been changed

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